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Immune Phenotype and Postoperative Complications following Elective Surgery.

Publication ,  Journal Article
Moris, D; Barfield, R; Chan, C; Chasse, S; Stempora, L; Xie, J; Plichta, JK; Thacker, J; Harpole, DH; Purves, T; Lagoo-Deenadayalan, S ...
Published in: Ann Surg
April 13, 2023

OBJECTIVES: To characterize and quantify accumulating immunological alterations, pre- and post-operatively in patients undergoing elective surgical procedures. SUMMARY BACKGROUND DATA: Elective surgery is an anticipatable, controlled human injury. Although the human response to injury is generally stereotyped, individual variability exists. This makes surgical outcomes less predictable, even after standardized procedures, and may provoke complications in patients unable to compensate for their injury. One potential source of variation is found in immune cell maturation, with phenotypic changes dependent on an individual's unique, lifelong response to environmental antigens. METHODS: We enrolled 248 patients in a prospective trial facilitating comprehensive biospecimen and clinical data collection in patients scheduled to undergo elective surgery. Peripheral blood was collected pre-operatively, and immediately upon return to the post- anesthesia care unit. Postoperative complications that occurred within 30 days after surgery were captured. RESULTS: As this was an elective surgical cohort, outcomes were generally favorable. With a median follow-up of 6 months, the overall survival at 30 days was 100%. However, 20.5% of the cohort experienced a postoperative complication (infection, readmission, or system dysfunction). We identified substantial heterogeneity of immune senescence and terminal differentiation phenotypes in surgical patients. More importantly, phenotypes indicating increased T-cell maturation and senescence were associated with postoperative complications and were evident pre-operatively. CONCLUSIONS: The baseline immune repertoire may define an immune signature of resilience to surgical injury and help predict risk for surgical complications.

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Published In

Ann Surg

DOI

EISSN

1528-1140

Publication Date

April 13, 2023

Location

United States

Related Subject Headings

  • Surgery
  • 11 Medical and Health Sciences
 

Citation

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Moris, D., Barfield, R., Chan, C., Chasse, S., Stempora, L., Xie, J., … Kirk, A. D. (2023). Immune Phenotype and Postoperative Complications following Elective Surgery. Ann Surg. https://doi.org/10.1097/SLA.0000000000005864
Moris, Dimitrios, Richard Barfield, Cliburn Chan, Scott Chasse, Linda Stempora, Jichun Xie, Jennifer K. Plichta, et al. “Immune Phenotype and Postoperative Complications following Elective Surgery.Ann Surg, April 13, 2023. https://doi.org/10.1097/SLA.0000000000005864.
Moris D, Barfield R, Chan C, Chasse S, Stempora L, Xie J, et al. Immune Phenotype and Postoperative Complications following Elective Surgery. Ann Surg. 2023 Apr 13;
Moris, Dimitrios, et al. “Immune Phenotype and Postoperative Complications following Elective Surgery.Ann Surg, Apr. 2023. Pubmed, doi:10.1097/SLA.0000000000005864.
Moris D, Barfield R, Chan C, Chasse S, Stempora L, Xie J, Plichta JK, Thacker J, Harpole DH, Purves T, Lagoo-Deenadayalan S, Hwang ES, Kirk AD. Immune Phenotype and Postoperative Complications following Elective Surgery. Ann Surg. 2023 Apr 13;

Published In

Ann Surg

DOI

EISSN

1528-1140

Publication Date

April 13, 2023

Location

United States

Related Subject Headings

  • Surgery
  • 11 Medical and Health Sciences